Diversion of mechanical oscillations

ABSTRACT

A device for deflecting mechanical oscillations, at an oscillation receiver location may be set into oscillation along a first axis, and transmits such an oscillation into an oscillation along a second axis at an oscillation output location, wherein the first and the second axis form an angle to one another. The device includes an elongate, bent oscillation element, on whose one end a coupling-in point and at whose other end a coupling-out point is arranged, wherein the device is designed such that the oscillation element oscillates transversally at the coupling-in point and at the coupling-out point, when the oscillation receiver location is subjected to an oscillation.

BACKGROUND OF THE INVENTION

The invention relates to the application of mechanical oscillations, forexample ultrasound oscillations, in situations in which limited spatialconditions limit the freedom of movement. It particularly relates to adevice for deflecting mechanical oscillations, in particular to asonotrode or a coupling piece.

Ultrasound processing apparatus are used increasingly in the medicalfield, amongst others, in dentistry. One example of an application ofultrasound apparatus in medicine, in particular dentistry, is a newlydeveloped method for anchoring implants and preparations in poroustissue. The method for example is described in the documents WO02/069,817, WO 2004/017,927 and WO 2004/017,857.

Ultrasound processing apparatus for medical use practically often havean elongate form with a handle, so that they may be used similarly to adentist's drill in the manner of a hand tool. The, for example,piezoelectric oscillation exciter excites a sonotrode into longitudinaloscillations which transmits these to a tool or a work piece. However,on account of the elongate form of the apparatus, the work at difficultyaccessible locations is made more difficult.

A sonotrode is known from EP 0 594 541, which is designed as an annularbending oscillator. The sonotrode oscillates about four node points,which renders possible a deflection of the oscillation about an angle of90°. The sonotrode may also oscillate about more than four nodes, sothat a deflection about another integer divider of 360° is possible, forexample about 120°. The disadvantage with the sonotrode of EP 0 594 541is that it takes up, relatively, much space on account of the annularconstruction. Moreover, only roughly half of the power coupled into thesonotrode is also coupled out into the tool or work piece. Yet anotherdisadvantage is the fact that a deflection is only possible about angleswhich are an integer divider of 360°. As a further disadvantage, onlysmall oscillation amplitudes are possible on account of the annulardesign.

An alternative procedure for the deflection of ultrasound is describedin the U.S. Pat. No. 6,139,320. A deflection channel contains a fluid,through which the longitudinal oscillations may be diverted according tothe shape of the deflection channel. Thereby, a disadvantage is the factthat energy is lost on account of a certain compressibility of thefluid, and the fluid is thereby heated.

It is accordingly an object of the invention, to provide solutions forthe deflection of mechanical oscillations, which overcome thedisadvantages of the ideas according to the state of the art and whichin particular is suitable for the application with restricted spatialconditions.

Solutions which permit a deflection between an oscillation receiverlocation and an oscillation output location by roughly 100°-130° areparticularly preferred, since the work at difficult to access locationsis often particularly easy at these angles.

BRIEF SUMMARY OF THE INVENTION

This object is achieved by the invention as is defined in the patentclaims.

A device according to the invention for deflecting mechanicaloscillations at an oscillation receiver location, may be set intooscillation along a first axis and transmits such an oscillation into anoscillation along a second axis at an oscillation output location,wherein the first and the second axis form an angle to one another. Thedevice at the oscillation receiver location is designed for connectingan oscillation exciter, and at the oscillation output location forconnecting a tool, work piece or intermediate piece. The device ischaracterised essentially by way of the fact that it comprises anelongate oscillation element bent between two ends, on which acoupling-in point and a coupling-out point are arranged, wherein thedevice is designed such that the oscillation element oscillatestransversally at the coupling-in point and at the coupling-out point,when the oscillation receiver location is subjected to an oscillation.

The mechanical oscillations are, for example, ultrasound oscillations.

The device according to the invention, according to the above teaching,thus acts as a sonotrode, wherein the term “sonotrode” does not meanthat the device must engage directly on the tool or work piece, butrather an intermediate piece may also be present, which transmits theoscillations from the sonotrode to a tool or work piece or a furtherintermediate piece.

By way of the fact that the oscillations are transversely tapped by theoscillation element, the oscillation element acts in the manner of a“hammer” which impinges a tool, work piece or intermediate tool which islateral with regard to the oscillation element axis, with oscillations.

It has been found that it is possible with the procedure according tothe invention, to produce oscillations with a good linearity at thecoupling-out point, i.e. oscillations whose component is very smalltransverse to the desired (transversal with respect to the oscillationelement) oscillation direction. It is possible to produce oscillationswhich run along a very longitudinally extended elliptical path, so thatto a very good approximation, one may assume oscillations along astraight line.

A firm, releasable coupling may be present between the device and thetool, work piece or intermediate piece, and also between the oscillationexciter and the device. The result of such a coupling is that the tool,work piece or intermediate piece completely participates in theoscillation at the oscillation output location, i.e. that in each case,both half-waves are transmitted. As an alternative, the transmission mayalso be effected by way of an only loose contact, wherein then onlycompression forces and no tensile forces may be transmitted.

The elongate bent design of the oscillation element means that alongitudinal axis and thus a longitudinal direction and transversaldirections are defined. The oscillation element may have the shape of abent rod of any cross section, wherein the cross-sectional area of therod does not need to be constant over its length. The coupling-in pointand the coupling-out point may in each case be located in the vicinityof one end of the rod. Additional elements may be fastened on the rod,for example masses, with which the amplitude ratio between oscillationsat the coupling-in point and coupling-out point may be influenced.

One recognition, on which the invention is based, is that thetransversal oscillations of such an oscillation element with anelongate, bent section, are suitable for deflecting mechanicalvibrations about different angles, which may be almost freely selectedby way of the choice of the geometry of the oscillation element.

Preferably, the oscillation element runs in a plane and oscillates inthis plane. The deflection angle is determined by the bending of theoscillation element in the plane, as well as by the position of thecoupling-in point and of the coupling-out point. An inner side and anouter side are defined by way of the bending in the plane. If thecoupling-out point lies on the outer side, the deflection anglecorresponds to the bending angle, thus to the angle between theoscillation element longitudinal axis at the coupling-in point and atthe coupling-out point. If in contrast, the coupling-out point islocated on the inner side, the deflection angle is 180° minus thebending angle.

Under certain circumstances—generally less preferred—a tapping of theoscillation at the oscillation element by an object (tool, work piece orintermediate piece) which is attached on the oscillation at the endside, is also possible. An “outside” coupling-out point then means thatthe tool, work piece or intermediate piece during the machining lies onthe outside with respect to the bending of the oscillation element, andan “inside” coupling-out point inversely means that it lies on theinside.

Practically any deflection angle with a large variability of outerdimensions is made possible by way of the selection of the bending angleand the coupling-in and coupling-out points. In contrast to the state ofthe art, its outer dimensions may be selected for a given deflectionangle, frequency and power, as well as a given amplitude ratio withincertain constraints, for example by way of the selection of the masscenters of gravity of two oscillation element halves (corresponding totwo oscillation element arms), the selection of coupling-in points andcoupling-out points (inside/outside) etc. The oscillation element may,for example, be bent “towards” the tool, work piece or intermediatepiece or “away therefrom”.

The case in which the bending angle is more than 90°, and thecoupling-in point as well as the coupling-out point lie on the outerside, is particularly preferably the case. This is particularlyfavourable for reasons of space, and a bending angle of more than 90°has been found to be particularly favourable also for reasons ofoscillation technology.

The preferred deflection angle is between 100° and approx. 130°,particularly preferably between 110° and 120°. The invention alsopermits deflection angles which are not integer dividers of 360°.

The oscillation element may, for example, have a shape which correspondsessentially to a sector of an arc of a circle, it may be V-shaped,O-shaped, hook-shaped etc. In embodiments with which it is not the wholeoscillation element which is uniformly curved, but with which thecurvature is particularly great in a curvature region (for example withthe V-shape or Ω-shape), the two arms connecting to the curvature regiondo not have to be equally long, but the oscillation element may have anasymmetrical shape. In any case, the oscillation element does not form aclosed ring but quasi an open ring of a uniform or non-uniformcurvature. This is advantageous from several aspects. On the one hand,much greater amplitudes than with an annular sonotrode are possible onaccount of the non-closed design. On the other hand, with an annularsonotrode, there are several sections between the nodes of theoscillation which oscillate. On application however, the oscillation ofeach such section is not utilised. The power which is required forsetting a non-used section into oscillation is thus lost. For thisreason, the efficiency of the design according to the invention isgenerally greater than an annular sonotrode according to the state ofthe art. Finally, the non-annular design is also advantageous since, asmentioned, practically infinite deflection angles may be realised, andthe space requirement is lower.

The cross section of the oscillation element does not need to behomogenous, but in contrast may vary. Such variations of the crosssection or of the arm lengths, as with the material selection,cross-sectional profiles, shape of the oscillation element and massdistribution, as well as positions of the coupling-in point and of thecoupling-out point and possible design of joints, additional elementsetc., may be used to influence the shape, natural frequencies andamplitude ratios of the natural oscillation. For example, an amplitudeamplification or amplitude reduction may be effected by way of theselection of the mass distribution between two arms.

The oscillation element may, for example, be designed similarly to thetwo arms of a tuning fork, wherein the two arms of the oscillationelement, in contrast to tuning forks which are used for tuning musicalinstruments, do not run parallel to one another, but at an angle, whichis adapted to the task.

The oscillation element is connected at the coupling-in point, forexample elastically, to an oscillation exciter of the apparatusproducing oscillations—for example ultrasound apparatus. An elasticconnection means that the stiffness of the connection (more preciselyits spring constant) is smaller than the stiffness of the oscillationelement itself and also smaller than that of other components of thedevice.

An elastic connection between the oscillation exciter and theoscillation element permits an oscillation corresponding to the naturaloscillation, to be formed with the excitation frequency, without themass center of gravity of the oscillation element—thus so to say theoscillation element as a whole—having to displace significantly during adeflection. This has a positive effect on the efficiency, since lesslarge masses need to be accelerated.

The connection between the oscillation exciter and the oscillationelement according to a first preferred embodiment may comprise a joint,for example an elastic joint. This, for example, acts in a hinge-likemanner, i.e. it permits tilt movements in one direction but not in adirection perpendicular thereto. The joint may be attached at the faceend of the oscillation element or also laterally. It is preferablydesigned as one piece with the oscillation element and a fasteningelement, and may have the shape of a necking, by way of which thematerial thickness is reduced locally, such that the joint permitspivoting in the oscillation element plane, but not perpendicularthereto.

The fastening element which may optionally be comprised by the device,serves for coupling the oscillation element to the oscillation exciter.It may, for example, be designed as a threaded pin and be screweddirectly onto the oscillation exciter. Should the fastening element bedesigned as one piece with a hinge and the oscillation element, thedevice under certain circumstances may comprise only a single component,which is also advantageous for the handling and with regard tomanufacturing technology aspects.

According to a further embodiment, the connection between a fasteningelement and the oscillation element or, if the device has no fasteningelement, directly between the oscillation exciter and the oscillationelement, may also be stiff and for example be present as a screwed,bonded or possibly locked-in, riveted or differently designedconnection.

If the device comprises a fastening element, the oscillation receiverlocation is mostly located on this. The fastening element may then bepin-like at least in regions, wherein the oscillation receiver locationis located at the one end-face of the pin-like region, and the otherend-face connects a transition region to the oscillation element, whichalso comprises the hinge.

Although a fixed (elastic or stiff) connection between the oscillationexciter and the device according to the invention may be advantageousdepending on the application, it is not necessary. Indeed, there neednot even be any material connection whatsoever between the oscillationexciter and the device according to the invention, but the connectionmay also be a loose one. The oscillation exciter may, for example, onlybe applied onto the device, wherein then the oscillation exciter mayonly act on the device by way of compressive forces (“only by knocks”),and may exert no tensile forces—the oscillation exciter “hammers” on thedevice. Thus a coupling between the oscillation exciter and the deviceonly exists for roughly a half wave. In this case, the excitationfrequency and the natural frequency of the device are advantageouslymatched to one another, for example by way of the excitation frequencycorresponding to a natural frequency or a harmonic of the naturalfrequency, or of an integer divider of the natural frequency of thedevice.

The oscillation output location mostly—but not necessarily—coincideswith the coupling-out point of the oscillation element. Suitablecoupling arrangements are provided at the oscillation output location,by way of which the tool, work piece or intermediate piece may betemporarily connected to the device such that a user of the apparatusduring the impinging of the tool, work piece or intermediate piece withmechanical oscillations, may guide this to the necessary extent, and inparticular exert a pressure thereon.

One coupling arrangement at the oscillation output location (thus mostlyat the coupling-out point) may, for example, contain a coupling pin onthe device, and which may engage into a corresponding hole in the tool,work piece or an intermediate piece. Such a pin may have any shape, forexample a cylindrical one with any cross-sectional shape, or a conicalone. However, inversely, a hole may be present in the device and acorresponding pin present in the tool, work piece or intermediate piece.These coupling arrangements are particularly simple in manufacture andhandling. Depending on the situation, there however exists the danger ofa jamming and angle errors may be produced.

Alternatively to the pin-hole coupling, a ball socket may be present onthe oscillation element or on the tool/work piece/intermediate piece,which cooperates with a corresponding ball of the counter-piece. Ajamming is avoided by way of this. A ball socket which is rotationallysecured by way of it not being cylinder-symmetrical, may be used insituations where the orientation of the tool/work piece/intermediatepiece during the machining must be defined by the apparatus producingoscillation—and in particular in which rotations about a longitudinalaxis are to be prevented. An analogous solution is also conceivable forthe pin-hole connection, with which one selects a shape which in crosssection is polygonal or is not rotationally symmetrical in anothermanner, in place of a rotation-cylindrical shape.

A fixed, elastic or a stiff connection between the device and the tool,work piece or intermediate piece, is not absolutely necessary, also atthe oscillation output location. Rather, there, the connection—in aguided or unguided manner—may lie in the device being applied onto thetool, work piece or intermediate piece and acting in the manner of ahammer. In the case of a fixed connection, a coupling may containadditional arrangements, by way of which tensile forces may betransmitted onto the tool, work piece or intermediate piece. Suchseparate arrangements, in the manner known per se, may comprise elementsengaging behind one another and running transversely to the vibrationdirection, for example in the manner of a bayonet locking, a thread orin another manner known per se.

The oscillation element may, for example, be manufactured of titanium orstainless steel. Alternatively to this, according to a particularembodiment, one uses a material for the oscillation element which has apermanent strength, i.e. whose stress-number curve tends asymptoticallyto a value different to zero, for a large number of load changes. Suchmaterials generally have a cubic-space-centred structure. Examples ofthis are ferritic steel, for example spring steel. This is not the casefor titanium or also for aluminium (a different usable material).Despite this, these materials are potentially suitable if theoscillation deflections of the oscillation element are small inoperation in comparison to the maximal possible deflection. Otherpossible materials are ceramics, metallic glasses or possibly otherglasses etc.

The subject matter of the invention is also an appliance for deflectingmechanical oscillation containing a first and a second device, which aredesigned in each case according to teaching specified above, wherein theoscillation output location of the first device is coupled to theoscillation receiver location of the second device, in a manner suchthat a transversal oscillation of the first device at its coupling-outpoint produces a transversal oscillation of the second device at itscoupling-in point. The range of the accessible deflection angle may beextended once again in comparison to the individual device by way ofthis appliance. Moreover, an additional variability results. Inparticular, a deflection in two planes is possible. For example, thesecond device may be controlled and rotated relative to the firstdevice. A suitable rotation direction may then be operated from the handgrip or via a suitable remote control, so that the user does not have todirectly handle the devices, which are not accessible in somesituations. Alternatively to this, the device may be also designed suchthat the two devices are fixed to one another at a defined angle. Thisdefined angle may, for example, be adapted ex situ.

One of the coupling arrangements discussed above may be present on thesecond device at the oscillation output location, by way of which atool, work piece (for example implant) or an intermediate piece iscoupled to the second device.

An ultrasound apparatus has an oscillation exciter, oscillation exciteractivating electronics and a device or an appliance, which is designedaccording to the above teaching.

The ultrasound apparatus in the case of a fixed coupling between theoscillation exciter and the device (sonotrode) is preferably operatedsuch that the excitation frequency lies below the (first) naturalfrequency of the oscillation element. An excitation frequency which isdifferent from the natural frequency is advantageous because then, theoutput amplitude may be easily controlled by way of the selection of theinput amplitude. In contrast to this, with an operation in resonance,the amplitude of the oscillation element (or of the oscillation at thecoupling-out point) is very difficult to control. Moreover, theoscillation element and the oscillation exciter do not need to bematched to one another in calibration. If the excitation frequency wereto lie above the natural frequency, then a frequency reduction onaccount of a large load during the application, may lead to thefrequency approaching the resonant frequency. With a loose couplingbetween the oscillation exciter and the device, the excitation frequencymay correspond to the resonant frequency or to an integer divider ofthis.

The operating frequency of the ultrasound apparatus preferably liesbetween 15 kHz and 40 kHz. With an operating frequency of 20 kHz, theresonant frequency of the oscillation element should preferably be atleast 1 kHz, even better at least 2 kHz higher than this. Verygenerally, the apparatus is operated advantageously at least 5% belowthe resonant frequency of the oscillation element.

The power of the ultrasound apparatus (i.e. the useful power of theoscillation exciter) is for example between 20 W and 150 W for theimplantation of dental implants, and the amplitude (after deflection) ofthe oscillation lies in the region between 10 μm and 80 μm, for examplebetween 20 μm and 80 μm. The required power depends on the mass of thetool/work piece (as the case may be, including possible intermediatepieces), on the damping, on coefficients of friction, etc. Under certaincircumstances, it is only about ⅕ of the above value for the CMFimplants which are relatively small compared to dental implants. Thepower of the ultrasound apparatus and the amplitude, depending on thenature of the implant (a fastening arrangement for a larger implant, forexample a pin for fastening a ball socket is valid as such) may vary ina large range for the implantation of implants for other surgicalapplications. The powers depend greatly on the selected application.They may lie, for example, between 0.5 W and 300 W or more—for exampleup to 2 kW—the amplitudes may lie between 5 μm and 200 mm.

The desired power determines the moment of inertia of the device. Thestiffness of the oscillation element is an important factor for this,which for its part is also determined by the cross-sectional area. Withan oscillation element of titanium for the implantation of dentalimplants at frequencies of 20 kHz, the cross-sectional area may, forexample, be between 10 and 50 mm².

A method for impinging an object with longitudinal, mechanicaloscillations and a surgical method are likewise the subject matter ofthe invention.

The device according to the invention and the appliance which is basedon it and the ultrasound apparatus are particularly advantageous incombination with surgical methods, since situations always occur, inwhich the space which is available is very limited and the ultrasoundapparatus may not be applied in any orientation.

The method according to the invention and the ultrasound apparatusaccording to the invention are on the one hand particularly advantageouswith the application in dentistry, cranio-maxillo-facial surgery andminimal invasive surgery (MIS). According to the initially mentioned,newly developed methods for fastening implants and preparations inporous material, the implant or the preparation are impinged withmechanical oscillation in situ, i.e. on the patient, and are driven intothe anchoring material. The device according to the invention permitsthe deflection of the mechanical oscillation about any angle, inparticular about angles in the region of about 110° to 120° which areergonomically favourable with intra-oral access, and which for exampledental drilling apparatus also envisage as an angle between the grip andthe drill. The device only requires little space in the mouth, and theoperating height is low, on account of the shape according to theinvention. This permits work also under difficult conditions, withpatients who find it difficult to open the mouth wide, and far to therear in the mouth. The device according to the invention is alsoadvantageous for other applications in the cranio-maxillo-facial (CMF)field of surgery. The invention also has advantages in the field ofengineering, in particular precision engineering.

The device particularly preferably comprises a cover in the manner of aprotective housing, which amongst other things may serve for preventingsecondary damage, by way of it shielding the body and tissue parts fromthe mechanically oscillating device. The cover may simultaneously alsocomprise a guide arrangement for holding and guiding the tool, workpiece or intermediate piece

One may envisage the outer dimensions of such a protective housing beingkept as low as possible for purposes of minimal invasive surgery. Forexample, the device and the housing which surrounds it may bedimensioned such that it would have space in a cylindrical tube with aninner diameter of maximally 8 mm.

Likewise, the device according to the invention, the appliance accordingto the invention and the ultrasound apparatus according to the inventionon the other hand are particularly advantageous for applications inimplantation surgery and bone surgery. For example, the sonotrodedesigned as a device according to the invention may also be advantageouswith surgical operations in combination with joint implants and spinalcolumn implants. It is generally suitable for fastening implants atdifficulty accessible locations in the human body, for example forfastening intervertebral disk implants between vertebrae. It is likewisesuitable for example for fixing the body's own tissue parts relative toone another.

A use of the device according to the invention, the appliance accordingto the invention or the ultrasound apparatus according to the invention,may also be advantageous for applications as are described in theinternational published application document WO 2005/009 256.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiment forms of the invention are explained in detail hereinafter byway of drawings. In the drawings there are shown in:

FIG. 1 a schematic representation of an ultrasound apparatus with asonotrode which is drawn set back, as well as of an implant and anintermediate piece,

FIG. 2 a view of a first embodiment of a sonotrode according to theinvention,

FIGS. 3a and 3b a view of two variants of a second embodiment of asonotrode according to the invention,

FIG. 4 a view of a third, multi-part embodiment of a sonotrode accordingto the invention,

FIGS. 5a to 5j schematic representations of possible shapes of theoscillation element,

FIGS. 6a to 6d schematic representations of possible coupling shapes forcoupling the oscillation element to a tool, work piece or intermediatepiece,

FIGS. 7a to 7e in each case, a schematic representation of a joint shapefor coupling the oscillation element to a fastening element,

FIG. 8 an arrangement with a first and a second sonotrode,

FIG. 9 one example for coupling two sonotrodes such that the secondsonotrode may not be rotated relative to the first sonotrode,

FIG. 10 an application example, specifically the fixation of a jointsocket,

FIGS. 11 and 12 in each case, a further application example from jointsurgery, specifically the fixation of a tibia-plateau implant(artificial tibia head) in two different manners,

FIG. 13 one application example from spinal column surgery, specificallythe fixation of an intervertebral disk to a vertebral body,

FIG. 14 a further example from spinal column surgery, specifically thefastening of a stabilising plate,

FIG. 15 a device according to the invention, with a protective housing,and

FIG. 16 a view of a further embodiment of a sonotrode according to theinvention.

DETAILED DESCRIPTION OF THE INVENTION

The schematically represented ultrasound apparatus according to FIG. 1is suitable for use as a hand apparatus. In the known manner, in ahousing 1, it contains a non-shown piezo oscillation quartz and atransmission arrangement for transmitting an oscillation of this to anexcitation exciter 2. The housing has an elongate basic shape, which istypical of instruments for dental application. A hand grip 3 is alsoschematically indicated in the drawing. Activation and excitationelectronics 4, which provide an output voltage which sets thepiezo-oscillation quartz into oscillation with the desired frequency andamplitude, are likewise shown in a schematic manner.

One may further recognise a sonotrode 5 in FIG. 1, which serves for thedeflection of mechanical oscillations, which are tapped at theoscillation exciter 2. If an oscillation receiver location 5.1 of thesonotrode is set into oscillation along the first axis 6.1 by way of theoscillation exciter, this produces an oscillation of an oscillationoutput location 5.2 along a second axis 6.2 which forms an angle α(deflection angle) to the first axis 6.1.

Likewise shown in a schematic manner in FIG. 1, are a dental implant 7and a plastic element 8 serving as an intermediate piece or a connectionpiece (for example of PEEK, a plastic which may be mechanical andthermally loaded to a great extent).

The sonotrode may be rotatable about its first axis 6.1, depending onthe application purpose and embodiment, which for example makes sense ifthe ultrasound apparatus is not essentially cylindrical as is shown, buthas a different shape which is not cylindrically symmetrical.

A first embodiment for a specific design of the sonotrode 5 according tothe invention is shown in FIG. 2. The fastening element contains athreaded pin 11. This is limited towards a transition region 12 by acollar 13. The oscillation element 14 is coupled at a face end to thetransition region 12 by way of a connecting joint 15. The oscillationoutput location coincides with the coupling-out point 14.2, at which theoscillation element comprises a coupling pin 16, to which—possibly viaan intermediate piece—a work piece (an implant for example) or a toolmay be coupled.

If the sonotrode at the oscillation receiver location is excited by anoscillation in the direction of the arrow 17—the oscillation correspondsto a longitudinal oscillation of the threaded pin—then a transversaloscillation of the oscillation element is excited at the coupling-inpoint via the joint 15 which defines the coupling-in point 14.1. A(fundamental) oscillation arises, with which the first arm 14.3 and thesecond arm 14.4 of the V-shaped oscillation element oscillate to oneanother in the manner of a tuning fork. On account of the action of thehinge-like joint, this oscillation does not entail a correspondingoscillation of the oscillation element mass center of gravity, butrather the first arm may “tilt away” from the transition region to thetop or the bottom, so that a neutral point 14.5 remains roughlystationary with the oscillation. The angle between the longitudinaldirection of the oscillation element at the coupling-in point 14.1 andthe longitudinal direction at the coupling-out point is 110°, i.e. theangle between the two arms 14.3, 14.4 is roughly 70°.

The cross-sectional shape (in a cross section perpendicular to thelongitude direction) of the oscillation element is roughly rectangular,such that the element has a greater width in the direction perpendicularto the plane of the drawing than in the other direction. This helps tosuppress oscillations perpendicular to the oscillation element plane.

The embodiment of the sonotrode according to FIG. 3a differs from thatof FIG. 2 in that the joint 15 does not connect on the end side, butlaterally to the oscillation element. A more compact construction manneris made possible by way of this, since the transition region of thesonotrode according to FIG. 2 may be done away with. The joint 15 isquasi knocked on account of a longitudinal oscillation (in the directionof the arrow 17) of fastening element 11. However, it has a similareffect as in FIG. 2, i.e. it permits a tilting-away of the oscillationelement, by which means the neutral point 14.5 may remain roughlystationary with the oscillation.

The—only schematically represented—variant of FIG. 3b differs from thatof FIG. 3a in that an additional mass 14.7 is present in the region ofthe first arm 14.3. The resonance characteristics of the device and thusthe oscillation behaviour at the oscillation output location and theloads in the region of the hinge 15 and the neutral point 14.5 may beinfluenced and optimised by way of this. The device according to FIG. 3baccordingly comprises:

a fastening element 11 which oscillates longitudinally on operation,which for example may be designed as a threaded pin,

a hinge 15 which connects thereto in the longitudinal direction,

an oscillation element 14 which is fastened on the hinge, and with afirst arm 14.3 and a second arm 14.4, wherein the hinge 15 is attachedon the first arm, and wherein the two arms may be straight or bent,

a bent or greatly bent region which is located between the first arm andthe second arm,

wherein a transition between the hinge 15 and the first arm 14.3 islateral with respect to the first arm,

wherein a counter-mass is present on the first arm on a side of thefirst arm 14.3 which lies opposite the bent region with respect to thementioned transition (i.e. the first arm extends “to the rear” beyondthe transition).

and wherein the fastening element and the oscillation element are of onepiece.

The embodiment according to FIG. 4 is similar to that of FIGS. 3a and 3b, but differs from this in that the sonotrode 5 is not of one piece, butthe fastening element 11 is separate from the oscillation element andmay be coupled to this by way of a connection element, for example ascrew (not drawn). Visible in the Figure are a through-hole 21 for thescrew, in the oscillation element, and a corresponding pocket hole 22 inthe fastening element 11. In each case the screwed connection may beessentially fixed or it may likewise act as a joint, depending on theelasticity of the screw material, as will yet be explained furtherbelow.

Whereas the oscillation excitation is effected “in axis” in theembodiments of the FIGS. 2-4, i.e. the elements between the oscillationexciter 2 and the oscillation element 14 all lie on a commonaxis—alternative possibilities are also conceivable. One suchalternative possibility is illustrated very schematically in FIG. 16.The fastening element has an L-shape, so that the application point ofthe oscillation element 14—formed by the hinge 15—is arranged offsetfrom the axis. Apart from the different geometry—this may beadvantageous depending on the application—the result of this is that thetransition region 12 may be set into tilt oscillations relative to thethreaded pin 11. These may have an influence on resonances of the systemand on the amplitude at the oscillation output location.

Very many schematic possible shapes of oscillation elements of asonotrode according to the invention are drawn in the FIGS. 5a to 5i .The oscillation elements may—as the case may be via joints—be fastenedto any fastening elements or directly on the oscillation exciter, or beformed as one piece with the fastening elements. They may comprisedifferent coupling arrangements. With all oscillation elements, oneassumes a deflection angle of roughly 100°-120°, and respectivemodifications for other angles are of course not only possible, but alsoevident.

The oscillation element 14 according to FIG. 5a is arc-shaped, i.e. iscurved over its whole length, wherein the curvature angle may beconstant, but does not need to be constant.

The oscillation element according to FIG. 5b is also arc-shaped. Itdiffers from that according to FIG. 5a in that the coupling-out point14.2 lies on the inner side, which is why the bending angle is 180°minus the deflection angle. The oscillation element is curved towardsthe work piece, tool or intermediate piece.

With the variants of the oscillation element which are drawn in thefollowing, the coupling-out point in each case is on the outer side.Modifications in the case of an inner coupling-out point are, however,possible in each of the drawn cases. In the case that the deflectionangle is to lie in the region between 100° and 130°, such a modificationentails a change of the bending angle to between 50° and 80°. As awhole, a range of bending angles between 50° and 130° which is generallyof interest, results.

The oscillation element according to FIG. 5c is V-shaped, i.e. two arms14.3, 14.4 connect to the bent section 14.6. The two arms may, but neednot have the same dimensions (length, cross-sectional area or course ofthe cross-sectional areas) or the same shaping (cross-sectional shape,surface nature etc.)

FIG. 5d shows an omega-shaped oscillation element, whilst FIG. 5e showsa hook-like oscillation element. The hook-like oscillation element maybe observed as a combination of the concepts of an omega-likeoscillation element (first arm 14.3) with a V-shaped oscillation element(second arm 14.4). Very generally, such combinations are possible thus,also arc-shaped-V-shaped, arc-shaped-omega-shaped etc.

In FIG. 5f , one sees an oscillation element which quasi may be observedas an intermediate solution between an omega-shaped and a V-shapedoscillation element. Such an oscillation element acts similarly to aV-shaped oscillation element, but is stress-optimised.

FIG. 5g shows one variant of the oscillation element of FIG. 5f ,wherein the thickness (thus the cross-sectional area) in the bentsection 14.5 is enlarged compared to the arms 14.3, 14.4. Such anoscillation element is somewhat stiffer than that of FIG. 5f , thus hasa higher natural frequency with given material characteristics

The oscillation element of FIG. 5h is likewise one variant of that ofFIG. 5f , wherein the two arms 14.3, 14.4 have different thicknesses andas a result also different masses. If as drawn, the arm 14.3 with thecoupling-in point has the larger mass, the oscillation element effectsan amplitude amplification.

Vice versa, the oscillation element of FIG. 5i , a variant of theoscillation element of FIG. 5c , has an extra mass 14.7 in the region ofthe coupling-out point, which results in a stepping down of theamplitude.

The oscillation element 14 of FIG. 5j between a middle part 14.12 andthe two arms 14.3, 14.4 in each case has a hinge-like narrowing 14.11,14.2. The narrowing reduces the stiffness of the oscillation element asa whole, and thereby, given the same size compared to an oscillationelement as in FIG. 5c , steps down the resonant frequency and thus,depending on the operating parameters, also the optimal workingfrequency. It is also possible to dimension the oscillation elementaccording to FIG. 5j comparatively smaller. By way of this, one maydesign the oscillation element such that with the same materials, theresonant frequency is in a similar region as with a larger oscillationelement according to FIG. 5c . A reduced stiffness of the oscillationelement is, thus, a way to miniaturize the oscillation and with this,the whole device.

The variants of the FIGS. 5g-5i may also be applied to the oscillationelements of the FIGS. 5a to 5e or 5 a, 5 b and 5 d to 5 f. Combinationsof the variants amongst one another are also possible.

FIGS. 6a to 6d show examples of coupling elements. In each case, an armof an oscillation element 14 which is on the coupling-out side is drawnin two different views or sectioned representations in the figures.

The coupling according to FIG. 6a is effected by the interplay of acoupling pin 16 with a corresponding recess 8.1 in the connection piece8. The reverse arrangement (hole 14.8 in the oscillation element, pin 31on the connection piece) is shown in FIG. 6b . This type of coupling issimple in manufacture and permits a simple coupling, but is howeverprone to angle errors and is not rotationally secure. If instead of acircularly cylindrical pin, one uses a different pin which is notcylinder-symmetrical—a polygonal, elliptical, star-shaped etc. crosssection may be selected—then a coupling analogous to FIG. 6a and FIG. 6bis rotationally symmetrical.

The ball socket coupling according to FIG. 6c provides the solution withregard to the proneness to angle errors. A ball element 32 of theconnection piece 8 cooperates with a recess 14.8 of the oscillationelement which is in the manner of a socket. This connection type islikewise not rotationally secure. However, a rotationally secure variantis also possible as shown in FIG. 6d . According to this embodiment, theconnection piece 8 has a ball element which is not cylinder-symmetricaland which cooperates with a corresponding deepening 14.9 of theoscillation element. The variants according to FIGS. 6c and 6d may ofcourse also be designed in the reverse arrangement. Further couplingvariants are conceivable, for example with slightly conical pins etc.

In addition to the drawn elements, a coupling may also contain aseparate arrangement, by way of which tensile forces may be transmittedonto the tool, work piece or intermediate piece. This undercircumstances is necessary with embodiments, with which a fixedconnection between the device and the tool, work piece or intermediatepiece is desired, and with which the friction forces and/or clampingforces of the above coupling arrangement are not adequate. Such aseparate arrangement, may, in the manner known per se, comprise elementsengaging behind one another and running transversely to the vibrationdirection, for example in the manner of a bayonet locking or in anothermanner known per se.

Different embodiments of connections between a fastening element 11 (or,as an alternative for embodiments which are not of one piece, theoscillation exciter) and the oscillation element 14 are drawn veryschematically in the FIGS. 7a to 7e . The joint 15 according to FIG. 7acorresponds to that which has already been previously explained. FIG. 7bshows a variant thereof. According to FIG. 7c , the joint is formed by ainhomogeneity of the material at the transition between the fasteningelement 11 and the oscillation element 14. In the transition region 41,the sonotrode consists of a material with a modulus of elasticity whichis smaller compared to the oscillation element and fastening element.According to FIG. 7d , the connection is a screw connection (as in FIG.4), wherein the screw 42 is extendable since it has a comparativelysmall diameter and/or is manufactured of a material with a smallermodulus of elasticity. Instead of being a screw connection, theconnection may also be effected in different comparable manners, forexample as a bayonet connection. FIG. 7e finally shows a variant of ascrew connection with a screw which may not be extended or notsignificantly extended, and a compressible spring element 43, which, forexample, may be fastened on the screw. Here too, another connectionarrangement is conceivable instead of a screw.

Variants with other geometries, fastening arrangements etc. are ofcourse possible.

In this text, the part of the device which as a whole has an elongateshape, is bent and executes the actual oscillation—analogously to thetwo prongs of a tuning fork—have been indicated above several times asan “oscillation element”. The coupling-out point is that location atwhich the oscillation is tapped from the oscillation element. In allillustrated embodiments, the oscillation output location coincides withthe coupling-out point. This is not a necessary precondition. Differingfrom this, the sonotrode may, for example, comprise a transition elementbetween the coupling-out point and the oscillation output location, andthis element has any geometric shape and through which the oscillations,for example as longitudinal oscillations, may be transmitted from thecoupling-out point to the oscillation output location. The couplingarrangement is then generally present at the end of the transmissionelement which is remote from the oscillation element. Such atransmission element may for example have the shape of a small rod whichis fixedly connected to the oscillation element and permits anapplication of the apparatus at sunk locations.

In all previously discussed examples, the coupling-in point and thecoupling-out point are located in each case in the vicinity of the endsof the oscillation element. This is not a necessity. Rather, theamplitude of the coupled-out oscillation may be influenced for exampleby way of the selection of the coupling-out. This is sketched by way ofexample in FIG. 5i by the double arrows. With a displacement of thecoupling-out point from the outer end 14.2 to the inside to alternativecoupling-out points 14.2′, 14.2″, one may reduce the amplitude in abasically infinite manner. The further the coupling-out point is appliedaway from the end of the oscillation element which is at the right inthe figure, the smaller is the amplitude of the coupled-out oscillation.Analogously of course, the coupling-out point may be displaced along thefirst arm. Moreover, a counter-weight may be present distally of thecoupling-out point, with which the amplitude and the resonant frequencymay be influenced. (If in FIG. 5i , the coupling-out point is applied atthe location 14.2″, then the extra mass acts as such a counter-weight).Alternatively or in a supplementary manner, such a counter-weight mayalso be provided distally of the coupling-in point.

These considerations concerning the coupling-in point and coupling-outpoint as well as counter-weights have been discussed by way of exampleand by way of the embodiment example according to FIG. 5i . Theyanalogously apply to all other oscillation element geometries.

One arrangement with two devices (sonotrodes) of the type according tothe invention, is drawn schematically in FIG. 8, which together form anappliance for deflecting mechanical oscillations. The first sonotrode 5is not in direct contact with the work piece or connection piece 8, butserves as a transition piece (converter), which deflects theoscillations taken at the oscillation exciter 2, about a firstdeflection angle and couples them into the second sonotrode 5′. This islikewise designed according to the invention and thus deflects theoscillations about a second deflection angle. The second deflectionangle with regard to the magnitude may be equally large as the firstdeflection angle, or the two deflection angles may be different.

The connection between the first and the second sonotrode may be fixedaccording to a first alternative. The orientation of the secondsonotrode relative to the first may however also be influenced. Forexample, the orientation may be set before the operation—ex situ—and mayfor example be fixed with a fixation screw.

According to a further alternative, the connection is movable and therelative orientation of the sonotrode may be changeable in situ. Thus,the second sonotrode may be rotatable about the second axis 6.2 of thefirst sonotrode. This may, for example, be effected by way of a rotationarrangement which may be operated from the ultrasound apparatus. Such arotation arrangement may comprise a force deflection arrangement and/ortorque deflection arrangement (pull cables) in the manner known per se,which, for example, may be set in operation by an electrical drive orpossibly by hand. Alternatively to this, a drive means of the rotationarrangement may also engage directly at the location of coupling betweenthe first and the second sonotrode. For example, an oscillation whicheffects a rotation of the second sonotrode, similarly to the principleof a piezoelectric motor, may be activated in the first sonotrode by wayof mechanical oscillations in a frequency range which is different tothe operating frequency, depending on the design of the sonotrode.

An alternative form of a coupling is drawn in FIG. 9, in which acoupling pin 16 of the one sonotrode and the corresponding recess of theother sonotrode are not cylinder-symmetrical, but for example, arerectangular in cross section. Such a coupling permits the arrangement ofthe two sonotrodes relative to one another in a discreet number ofdefined orientations. The two sonotrodes are fixed in an orientationwhich is selected once, and an adaptation of the orientation is onlypossible ex situ by way of removing the coupling pin 16 of the onesonotrode from the corresponding recess of the other sonotrode, andreintroduction in another orientation.

FIG. 10 shows a method, with which the sonotrode according to theinvention and also the device for deflecting mechanical oscillations maybe applied. A pelvis 51 is shown very schematically and sectioned, inwhich an artificial acetabulum 52 is applied. This is effected with aplurality of implants 53, which are designed according to the principledescribed in the documents WO 02/069,817 and WO 2004/017857.

In a first step, the acetabulum is placed according to methods known perse. Subsequently, implants of the mentioned type are led through theopenings 52.1 envisaged for these, and are subsequently anchored in theporous bone material by way of liquefying thermoplastic or thixotropicmaterial on their surface by way of the application of mechanicaloscillations. Optionally, bores may be incorporated into the bone beforethe application of the mechanical oscillations, so that the introductionof the implants may be effected with little force effort. The implantsmay be formed such that on being subjected to mechanical oscillations, atype of head forms on the proximal side, by way of which the artificialacetabulum is fixed. Alternatively to this, a premanufactured head mayalso be present, and/or an infiltration of thermoplastic material of theimplant into a porous surface section of the acetabulum may occur. As afurther alternative, the acetabulum may comprise regions of plastic, anda welding of these regions to regions of the implant occurs.

The advantages of the invention are particularly manifest with themethod according to FIG. 10, wherein the different implants must bedriven into the bone at different angles. This is possible in a verysimple manner by way of the deflection of mechanical oscillations with asonotrode according to the invention. The use of a device according toFIG. 9 is particularly advantageous, in particular if the secondsonotrode may be rotated relative to the first by the user with arotation means device in situ—thus without having the remove theapparatus from the operation location.

Even if the example of an acetabulum is drawn in FIG. 10, an analogousmethod is also conceivable for other comparable operations, for examplefor a shoulder joint.

FIG. 11 shows the fixation of a tibia-plateau implant 61 according to afirst variant. The tibia plateau implant 61 comprises predefined,open-pored, porous zones 61.1. In a first step it is brought into itsfinal position on the tibia bone 62 by way of methods known per se.Subsequently, a (thermoplastic or possibly thixotropic) polymer isintroduced through the porous zones 61.1 which is effected by way ofsubjecting a preparation 63 designed as a polymer body, to mechanicaloscillations and simultaneous pressing against the porous zones. Thepolymer, apart from the porous zones, also infiltrates the bone and thusensures a primary stability. The porous zones as a result areadvantageous with osseo-integration and permit the tibia-plateau implantto grow well together with the bone.

A procedure which is analogous to FIG. 11—the introduction of a polymerpreparation through porous zones—may also be applied if a ball socketmay be fastened on the bone.

The second variant for the fixation of a tibia-plateau implant 71 on thetibia bone 62, as is shown in FIG. 12, is based on the method accordingto the documents WO 02/069,817 and WO 2004/017 857. A tibia bone 62 withthe tibia plateau implant 71 is drawn on the left in the figure beforethe implantation of a second implant 73, and on the right one can see acut-out with an implanted implant. The tibia-plateau implant is firstlybrought into its final position by way of methods known per se, whichalso include the operative preparation of the tibia bone. Subsequently,implants 73, whose surfaces at least partly comprise a thermoplastic orthixotropic polymer 73.1, are driven into the bone throughpremanufactured openings 71.1 of the tibia-plateau implant. Here too,prior bores may be optionally previously incorporated in the bone. Aswith the method according to FIG. 10, the implants 73 may be designedsuch that a type of head forms on the proximal side on being subjectedto mechanical oscillation, by way of which head the artificial tibiahead is fixed. Alternatively to this, a premanufactured head 73.2 mayalso be present, and/or an infiltration of thermoplastic material of theimplant into a porous surface section of the artificial tibia head mayoccur, or the implant in regions may be welded to the latter. In thedrawn embodiment, the implant has a hard core 73.3, for example oftitanium or another suitable, non-deformable material.

The tibia head during an operation, as with those according to FIGS. 11and 12, is accessible from the side, but mechanical oscillations and thepressure must however be applied from above or obliquely from above. Forthis reason, the use of a sonotrode according to the invention whichdeflects mechanical oscillations about a deflection angle isparticularly advantageous here. A device according to FIG. 9 may also beapplied.

Methods from vertebral column surgery are yet shown in the FIGS. 13 and14, which may be realised with the procedure according to the invention.

FIG. 13 shows the fixation of an artificial intervertebral disk (i.e. anintervertebral disk implant) on the vertebral bodies of the two adjacentvertebrae. A standard intervertebral disk implant may be used as anintervertebral implant 81. This is firstly placed with methods known perse between the vertebral bodies. Subsequently, implants 82 areintroduced with the method according to the documents WO 02/069,817 andWO 2004/017 857, in order to fasten the implant. Thereby, polymermaterial which is liquefied by way of subjecting it to mechanicaloscillations, infiltrates porous material of the vertebral bone 83 andaccording to a first variant also porous material of the intervertebraldisk implant 81. According to a second variant, the polymer material ofthe implant 82 melts in a superficial manner with intervertebral diskimplant material in the manner of an ultrasound welding. According tofurther variants, the fixation of the intervertebral disk implant iseffected as mentioned with the previously described embodiment examplesby way of a (sunk) head which is preformed, or forms on introduction.

Also with the method according to FIG. 13, the deflection of mechanicaloscillations by way of the device according to the invention and, as thecase may be the appliance according to the invention has a greatadvantage, since the implants 82 may be driven into the bone at a verydifficulty accessible location and at an angle.

FIG. 14 finally shows a plate 91 which is fastened on two vertebrae andmay be used for stabilising the vertebral column. The plate at least inregions is manufactured of elastic material and may be pressed togetherand stretched as is symbolized by the double arrow, wherein the middlepart deforms. It is preferably fastened by way of implants 92 which arenot circular in cross section, by which means a complete mechanicalstability results even if, as a whole, only two implants 92 are used forfastening. The method which is shown in the documents WO 02/069,817 andWO2004/017 857 and discussed by way of the previous embodiment examples,is used for the fastening of the implants in the bone material, and theplate 91 on the implants.

The surgical methods shown in the above figures may in particular beminimal invasive.

The implants shown in the above figures are all based on the principlethat thermoplastic material is present at least partly on their surfaceand this material may be liquefied in contact with hard tissue by way ofmechanical oscillation. Alternatively to this drawn procedure, theimplants—or at least one thereof—may also comprise a sleeve with aplurality of openings, which may not be liquefied by the mechanicalvibrations, wherein liquefiable material is present in the inside of thesleeve, which is liquefied with the implantation process by way of themechanical vibrations, and is pressed outwards through the openings inthe sleeve and interpenetrates the porous structures of the hard tissue.Such implants are also known from the state of the art, for example fromWO 02/069,817.

Many further surgical methods are conceivable with which the applicationof the sonotrode according to the invention, the device according to theinvention or the apparatus according to the invention is advantageous.

The surgical methods described in the FIGS. 10-14 may also be realisedwith apparatus and sonotrodes producing mechanical oscillation, otherthan those described and claimed here, which is less preferred.

With the use of device according to the invention for surgical, dentalor orthodontic methods, it may be desirable to shield tissue parts fromthe mechanical vibrations in order to avoid secondary damage. This maybe effected by a protective housing 101, which is illustrated veryschematically in FIG. 15. The protective housing may, thus, be formedsuch that it may be attached directly on the housing of the apparatusproducing the vibrations by way of first guide means, here through afirst opening 101.1, so that the relative position of the sonotrode 5and the protective housing 101 is fixed by way of this, and nocomplicated vibration-decoupling mounting of the sonotrode in theprotective housing is necessary. In the non-operative condition, thesonotrode may be held at its location relative to the housing by way offixation means, from which it is decoupled in the operative condition,wherein the decoupling may be effected by way of attaching onto thesonotrode.

The protective housing particularly preferably comprises second guidemeans, with which holding means for the tool, the work piece orintermediate piece may be led. These are formed by a second opening101.2 in a very schematically drawn embodiment example.

What is claimed is:
 1. A device for deflecting mechanical oscillations,comprising: an oscillation receiver location designed for the connectionof an oscillation exciter; an oscillation output location; and a bent,elongate oscillation element comprising a coupling-in point and acoupling out point, wherein oscillations along a first axis coupled intothe oscillation receiver location set the oscillation element intotransversal oscillation at the coupling-in point and cause a flexuralvibration of the oscillation element, whereby the oscillation elementtransmits oscillations from the oscillation receiver location to thecoupling out point, the oscillation element oscillating transversally atthe coupling-out point, wherein transversal oscillations of theoscillation element at the coupling-out point cause an oscillation atthe oscillation output location along a second axis, wherein the firstaxis and the second axis form an angle to one another, whereinoscillation output location comprises a coupling element equipped forthe connection of a tool, a work piece, or an intermediate element, andwherein the device further comprises a counter element lying oppositethe oscillation element with respect to the coupling-in point andinfluencing a resonance characteristics of the device.
 2. The deviceaccording to claim 1, wherein the oscillation element and the countermass are of one piece.
 3. The device according to claim 1, furthercomprising an oscillation exciter portion that comprises the oscillationreceiver location.
 4. The device according to claim 3, wherein theoscillation exciter portion, the oscillation element and thecounter-mass are all of one piece.
 5. The device according to claim 1,wherein an angle between a longitudinal direction of the oscillationelement at the coupling-in point and a longitudinal direction of theoscillation element at the coupling-out point is more than 90°.
 6. Thedevice according to claim 1, comprising an oscillation exciter portion,the oscillation exciter portion being connected to the coupling-in pointby a joint and being one-piece with the oscillation element, wherein theoscillations that are coupled into the oscillation receiver location arelongitudinal vibrations of the oscillation exciter portion.
 7. Thedevice according to claim 1, wherein the angle between the first axisand the second axis is between about 100° and about 130°.
 8. The deviceaccording to claim 1, wherein the oscillation element has an essentiallyconstant cross section over its length.
 9. A device for deflectingmechanical oscillations, comprising: an oscillation receiver location;an oscillation output location; and an elongate oscillation elementcomprising a coupling-in point and a coupling out point, whereinoscillations along a first axis coupled into the oscillation receiverlocation set the oscillation element into transversal oscillation at thecoupling-in point and cause a flexural vibration of the oscillationelement, whereby the oscillation element transmits oscillations from theoscillation receiver location to the coupling out point, the oscillationelement oscillating transversally at the coupling-out point, whereintransversal oscillations of the oscillation element at the coupling-outpoint cause an oscillation at the oscillation output location along asecond axis, wherein the first axis and the second axis form an angle toone another, wherein oscillation output location comprises a couplingelement equipped for coupling the oscillation at the oscillation outputlocation into a tool, a work piece, or an intermediate element, whereinthe oscillation element extends arc-shaped between the coupling-in pointand the coupling-out point.
 10. A device for deflecting mechanicaloscillations, comprising an oscillation receiver location; anoscillation output location; and a bent, elongate oscillation elementcomprising a coupling-in point and a coupling out point, whereinoscillations along a first axis coupled into the oscillation receiverlocation set the oscillation element into transversal oscillation at thecoupling-in point and cause a flexural vibration of the oscillationelement, whereby the oscillation element transmits oscillations from theoscillation receiver location to the coupling out point, the oscillationelement oscillating transversally at the coupling-out point, whereintransversal oscillations of the oscillation element at the coupling-outpoint cause an oscillation at the oscillation output location along asecond axis, wherein the first axis and the second axis form an angle toone another, wherein the oscillation output location coincides with thecoupling-out point and comprises a coupling element equipped forcoupling the oscillation at the oscillation output location into a tool,a work piece, or an intermediate element, said coupling elementextending sideways from the oscillation element with respect to anoscillation element axis.
 11. The device according to claim 10, whereinthe oscillation element runs in a plane and the flexural vibration ofthe oscillation element are oscillations in the plane.
 12. The deviceaccording to claim 11, wherein the coupling element is arranged on anouter side of the bent, elongate oscillation element.
 13. The deviceaccording to claim 10, wherein the coupling element is a coupling pinextending sideways away from the oscillation element and being one-piecewith the oscillation element.
 14. The device according to claim 10,wherein an angle between a longitudinal direction of the oscillationelement at the coupling-in point and a longitudinal direction of theoscillation element at the coupling-out point is more than 90°.
 15. Thedevice according to claim 10, comprising an oscillation exciter portion,the oscillation exciter portion being connected to the coupling-in pointby a joint and being one-piece with the oscillation element, wherein theoscillations that are coupled into the oscillation receiver location arelongitudinal vibrations of the oscillation exciter portion.